crossing96/oncoscreening huggingface dataset:
Cisplatin-induced AKI risk stratification and safety of dose reduction in urothelial carcinoma patients with renal impairment.	INTRODUCTION AND OBJECTIVES: Cisplatin is essential for treating urothelial carcinoma but poses a high risk of AKI. Previous studies on CP-AKI risk factors had limitations. Gupta et al. (2020) proposed a simplified risk score linked to CP-AKI and 90-day survival, though validated only in patients with eGFR ≥50 mL/min. MATERIALS AND METHODS: This single-center retrospective study analyzed 70 patients with urothelial carcinoma treated with cisplatin. Patients with eGFR ≥50 mL/min received full-dose cisplatin (n = 47); those with eGFR 30-49 mL/min received a 75% reduced dose (n = 23), per Japanese guidelines. All received intravenous magnesium. AKI was defined as a ≥ twofold rise in serum creatinine or initiation of renal replacement therapy. The study also evaluated the Gupta score's association with 90-day survival in metastatic cases. RESULTS: AKI occurred in 9.3% of the full-dose group and 4.5% of the reduced-dose group (p = 1.000). Higher Gupta scores were significantly associated with lower 90-day survival (p = 0.003). CONCLUSION: A 75% cisplatin dose reduction in patients with moderate renal impairment appears safe and maintains efficacy without increasing AKI risk. These findings support personalized dosing and highlight the need to refine clinical guidelines. Further prospective studies are warranted.	bladder
Neoadjuvant chemoradiotherapy plus programmed cell death protein-1 blockade versus chemoradiotherapy alone for muscle-invasive bladder cancer: a real-world comparative study.	INTRODUCTION: Muscle-invasive bladder cancer (MIBC) has a high risk of recurrence and mortality despite radical cystectomy. Neoadjuvant chemoradiotherapy (NACRT) offers has been investigated as a bladder-preserving strategy in selected patients; however, in this study, all patients underwent radical cystectomy following NACRT, and programmed cell death protein-1 (PD-1) inhibitors have shown antitumor activity in urothelial carcinoma. Combining NACRT with PD-1 blockade may enhance tumor response; however, its pathological benefits and short-term safety remain unclear. This study aimed to compare pathological response and short-term safety between NACRT alone and NACRT combined with PD-1 blockade (NACRT + PD-1) in patients with MIBC. METHODS: A retrospective review was conducted for 59 consecutive patients with MIBC (cT2-T4aN0M0) treated at the First Affiliated Hospital of Soochow University between January 2021 and December 2024. Twenty-seven patients received NACRT alone, and 32 received NACRT plus a PD-1 inhibitor-toripalimab (n=18) or tislelizumab (n=14). Chemotherapy comprised gemcitabine 1,000 mg/m² (days 1 and 8) and cisplatin 70 mg/m² (days 2-3) every 21 days for ≥3 cycles. Intensity-modulated pelvic radiotherapy delivered 45 Gy in 25 fractions plus a weekly boost (10 Gy in five fractions) to the bladder. The PD-1 antibody (toripalimab 200 mg or tislelizumab 240 mg) was infused on day 8 of each cycle. The primary endpoints were pathological downstaging rate (PDR, ≤ypT1/Tis/TaN0M0) and pathological complete response rate (PCRR, ypT0N0M0). The secondary endpoint was treatment-related adverse events (AEs) graded using the Common Terminology Criteria for Adverse Events version 5.0. Group comparisons used χ², Fisher's exact, or non-parametric tests as appropriate (two-sided, α=0.05). RESULTS: Baseline demographics and clinical characteristics were balanced between the groups (all p > 0.05). After radical cystectomy, pathological stage distribution did not differ significantly (p > 0.05). The PDR was 74.07% (20/27) in the NACRT group and 87.50% (28/32) in the NACRT + PD-1 group (p=0.187). The PCRR increased from 44.44% (12/27) with NACRT alone to 71.88% (23/32) with PD-1 addition (p=0.033). Toripalimab and tislelizumab achieved comparable PDRs (83.33% vs. 92.86%, p=0.613) and PCRRs (66.67% vs. 78.57%, p=0.694). No grade ≥4 AEs or treatment-related deaths occurred, and AE frequencies were similar between groups (all p > 0.05). CONCLUSION: NACRT combined with PD-1 blockade significantly improved PCRR without increasing toxicity in patients with MIBC. These findings support conducting a prospective single-arm phase II multicenter trial to confirm potential long-term survival benefits.	bladder
Renal, bladder and prostate cancer surgery outcomes with respect to team familiarity.	OBJECTIVES: To investigate outcomes in urological oncology according to team membership and familiarity. SUBJECTS/PATIENTS: We assessed peri-operative times, lengths of stay and re-admission rates in all patients undergoing surgery for prostate, bladder and kidney cancer at Sheffield Teaching Hospitals from 2021 to September 2024. Our analysis was performed with respect to staff pairs and a validated familiarity score (FS) derived using seven team members. RESULTS: In total, 1043 patients, 319 staff members and 3791 staff combinations were included. The mean (sd) FS for all cases was 14.2 (7.2), and was 13.7 (7.3), 9.3 (4.1) and 16.7 (7.1) for renal, bladder and prostate surgeries (anova, P < 0.001), respectively. Teams with higher familiarity had shorter times for all peri-operative intervals (anova, P < 0.041), shorter lengths of stay (1.94 vs 5.3 days; anova, P < 0.001) and fewer readmissions within 30 days (4.1% vs 8.0%; chi-squared test, P = 0.01). Greater familiarity led to savings of 26.2, 44.2 and 12.8 min for renal, bladder and prostate surgeries, respectively. In multiple regression, using preoperative features, greater familiarity was associated with fewer total case min (each 1-unit increase in FS equated to -1.88 min; 95% confidence interval -2.25 to -1.29; P < 0.001). Regarding team dyads, the greatest difference in total case duration was for the Surgeon #1/Surgeon #2 combination (average 40.8-min saving). Increased anaesthetic familiarity (with anaesthetic assistant) was associated with shorter anaesthetic room durations (anova, P = 0.007) and shorter delays leaving theatre (P < 0.001). CONCLUSION: Greater team familiarity was associated with faster surgical times and shorter lengths of stay. The time savings could be used to improve theatre usage and efficiency.	bladder
Vitamin C enhances cisplatin sensitivity in bladder cancer via 5hmC-mediated epigenetic modulation of ATF4.	Cisplatin resistance remains a major challenge in the clinical treatment of bladder cancer (BC), and the epigenetic regulation of this resistance, particularly involving 5-hydroxymethylcytosine (5hmC), has not been fully elucidated. Here, we investigated the role of 5hmC and vitamin C (VC) in modulating cisplatin sensitivity in BC. Clinical analyses of 36 BC patients receiving cisplatin-based neoadjuvant chemotherapy showed that reduced 5hmC levels in pre-chemotherapy tumor tissues were significantly associated with cisplatin resistance (CR-BC) and poor prognosis, with low 5hmC correlating with shorter progression-free survival (PFS). In vitro, we established two cisplatin-resistant cell lines (T24-CR, UMUC-3-CR) that exhibited reduced 5hmC compared to parental cells. Treatment with 100 μM VC significantly restored 5hmC levels in CR-BC cells by activating TET enzymes, inhibited cell proliferation, and enhanced cisplatin sensitivity; these effects were abrogated by the TET inhibitor Bobcat339, confirming VC acts in a TET-dependent manner. Mechanistically, genome-wide 850 K methylation array and RNA-seq analyses revealed that VC upregulated methylation specifically at the promoter of ATF4, a downstream effector of the MAPK pathway, thereby downregulating ATF4 expression. ATF4 knockdown in CR-BC cells increasing cisplatin sensitivity, while Bobcat339 reversed VC-induced ATF4 downregulation. In vivo, VC combined with cisplatin significantly inhibited tumor growth in T24-CR xenografts, and co-treatment with ATF4 knockdown further enhanced this effect, accompanied by elevated 5hmC and reduced Ki67 in tumors. Collectively, our findings identify reduced 5hmC as a hallmark of cisplatin-resistant BC and reveal a novel mechanism by which VC enhances cisplatin sensitivity. VC activates TET enzymes to increase 5mC at the ATF4 promoter, downregulating ATF4 and modulating the MAPK pathway. This highlights VC as a potential epigenetic adjuvant to overcome cisplatin resistance in BC.	bladder
Gene signature for response prediction to immunotherapy and prognostic markers in metastatic urothelial carcinoma.	To date, immune checkpoint inhibitors (ICIs) have emerged as a leading treatment for metastatic cancer, significantly improving patient survival while causing relatively few side effects. However, the objective response rate for ICIs remains low approximately 30% in urothelial carcinoma (UC), underscoring the urgent need for predictive response biomarkers. Several state-of-the-art signatures have been revealed in top-tier journals, highlighting the importance of this field. As the number of genes (~20,000) far exceeds the sample sizes of typical training sets (generally ≤ 300), we first developed feature selection procedures to reduce the number of features to a few hundred. We then trained multiple machine learning classifiers using the selected genes and the IMvigor210 dataset, which includes RNA-seq and clinical data from ~298 patients with metastatic UC (mUC). Notably, our predictor LogitDA, using the identified 49-gene signature, achieved a prediction AUC of 0.75 in an independent dataset, PCD4989g(mUC). Moreover, our signature outperformed six state-of-the-art signatures, PD-L1 IHC, and five tumor microenvironment signatures, including IFN-γ, T-effector, and T-cell exhaustion signatures. When we integrated each of the six known signatures with our own, our signature still surpassed the integrated ones in terms of prediction AUC and accuracy in the PCD4989g(mUC) dataset. From our signature, we identified key prognostic biomarkers, with the top five markers LYRM1, RFC4, CENPL, SPAG5, and CACYBP (Benjamini-Hochberg adjusted P < 0.0025) in the IMvigor210 dataset. Finally, we performed pathway analyses using Reactome (MSigDB) and KEGG, to reveal some immune-related pathways enriched such as MHC class II antigen presentation.	bladder
Hollow Dodecahedral Nanocages for Reliable Multi-Level Differentiation of Urological Cancers through Non-Invasive Metabolic Fingerprinting.	Urological cancers, including bladder cancer (BCa), prostate cancer (PCa), and renal cancer (RCa), represent the most common malignancies of the urinary system and account for a significant proportion of global cancer-related morbidity and mortality. Despite advances in imaging and pathology, achieving accurate and tiered differentiation among these entities remains clinically challenging due to overlapping symptoms, heterogeneous progression patterns, and limited noninvasive diagnostic tools. Herein, we developed hollow dodecahedral trimetallic oxide nanocages (TONCs) via a metal-organic framework (MOF)-derived synthesis strategy. Leveraging synergistic compositional and structural features, the TONCs exhibited enhanced photoresponsive behavior, thermal conductivity, and stability. As a high-performance matrix for LDI-MS, TONCs enabled the direct analysis of urine samples within seconds while minimizing background interference and improving ionization efficiency. Combined with Gradient Boosting, the approach achieved robust multiclass classification with area under the curve (AUC) values of 0.940 (training set) and 0.944 (testing set). Furthermore, nine m/z features were selected to construct a simplified yet effective urological cancer differentiation platform (UC-D9), which retained a high classification performance. Pathway analysis elucidated the underlying metabolic mechanisms associated with these malignancies. Together, this study provides a clinically translatable strategy for high-throughput metabolomic profiling, offering a promising tool for the noninvasive, accurate, and multilevel differentiation of urological cancers.	bladder
Association of urinary tract infection and low albumin/globulin ratio with chemoresistance to gemcitabine-cisplatin in advanced urothelial carcinoma.	OBJECTIVE: Urothelial carcinoma (UC) remains a prevalent malignancy with high recurrence and chemoresistance rates despite gemcitabine-cisplatin (GC) chemotherapy. The study aimed to identify clinical risk factors for chemoresistance in advanced UC patients and develop a predictive model. METHOD: A retrospective analysis was conducted on 375 UC patients who received postoperative GC chemotherapy between 2013 and 2024. Patients were categorized into chemotherapy-resistant (CR, n = 91) and non-chemotherapy resistant (NCR, n = 284) groups based on tumor progression. Clinical, pathological, and laboratory variables were compared using t-tests and chi-square tests. Kaplan-Meier assessed overall survival (OS), and binary logistic regression identified independent predictors of chemoresistance. RESULT: Overall survival (OS) was significantly lower in the CR group than in the NCR group urinary tract infection (OR: 54.60; 95% CI: [21.19, 140.67]) and low A/G (OR: 0.18;95% CI: [0.03, 0.94]). The prediction model was: Logit(P)=-3.69+0.96×multifocal tumor+1.05×Tstage+4.00×long-termurinary tract infection(UTI)-1.73×A/G. CONCLUSION: Multifocality, high T stage, persistent UTI, and low A/G ratio are significantly associated with chemoresistance to GC in UC. These routine clinical indicators may support early identification of high-risk patients and guide treatment decisions.	bladder
[Application of NeoVI-RADS scoring in patients with bladder cancer undergoing neoadjuvant therapy].	Objective: To evaluate the utility of neoadjuvant vesical imaging-reporting and data system (NeoVI-RADS) in predicting tumor residuals and diagnosing muscle-invasive bladder cancer (MIBC) in patients undergoing neoadjuvant therapy, as well as its application in prognostic stratification. Methods: A retrospective case series analysis was conducted on the clinical data of 91 patients with bladder cancer who received neoadjuvant therapy at the Department of Urology, First Affiliated Hospital of Nanjing Medical University from July 2014 to June 2024. There were 84 male cases and 7 female cases, with an age of (66±9) years (range:45 to 85 years). The clinical staging of the patients was ≥T2 based on imaging. All of them underwent three or more cycles of neoadjuvant therapy, and had post-treatment multiparametric MRI (mp-MRI) evaluation. Based on the results of mp-MRI, the NeoVI-RADS was established and employed to assess tumor residuals and muscle invasion. The receiver operating characteristic curve was plotted, and the area under the curve (AUC) was calculated. Kaplan-Meier survival curves based on overall survival (OS) and cancer-specific survival (CSS) were plotted, and the Log-rank test was used for survival analysis comparison between groups. Results: In the neoadjuvant treatment cohort, the AUC for predicting tumor residuals post-neoadjuvant therapy using NeoVI-RADS was 0.900, with an accuracy of 93.4%, sensitivity of 95.8%, and a specificity of 85.0%. The NeoVI-RADS demonstrated strong diagnostic performance for MIBC, achieving an AUC of 0.900. At a NeoVI-RADS score cutoff of 4, the accuracy was 84.5%, with a sensitivity of 87.5% and a specificity of 72.9%. Additionally, compared to patients with NeoVI-RADS scores of 0 (5-year OS and CSS rates both 100%) or scores of 1 to 3 (5-year OS and CSS rates both 90.9%), patients with scores of 4 to 5 had significantly worse OS (5-year rate 63.0%) and CSS (5-year rate 66.3%) (all P<0.05). There was no statistically significant difference in OS or CSS between patients with NeoVI-RADS scores of 0 and those with scores of 1 to 3 (all P>0.05). Conclusion: NeoVI-RADS demonstrates significant diagnostic and prognostic value in the context of neoadjuvant treatment for bladder cancer, effectively assessing tumor residuals and muscle invasion, thereby enhancing patient management and facilitating personalized treatment approaches.	bladder
CircPSMA4 as a novel circular RNA enhances the proliferation migration invasion and metabolism of bladder cancer cells through the miR-767-3p/HIF1A pathway.	To investigate the expression characteristics, functional roles, and regulatory mechanisms of circPSMA4 via miR-767-3p/HIF1A in bladder cancer. The expression and in vitro functionality of circPSMA4 in T24 bladder cancer cell lines were analyzed using RNase R treatment, actinomycin D stability assay, nucleocytoplasmic separation, real-time quantitative PCR, Western blot, dual-luciferase reporter assay, cellular energy metabolism analysis, scratch assay, Transwell migration and invasion assay, CCK-8 proliferation assay, lactate and glucose uptake detection, and ATP production measurement. Further, the in vivo roles of circPSMA4 were validated through the construction of stable cell lines and tumor xenograft assays in nude mice. CircPSMA4 was identified as a circular RNA highly expressed in bladder cancer cells, directly interacting with miR-767-3p. CircPSMA4 functions as a miR-767-3p sponge, regulating miR-767-3p to influence the expression of HIF1A, thereby promoting the proliferation, migration, invasion, and metabolic activities of bladder cancer cells, as well as tumor formation. CircPSMA4 facilitates the proliferation, migration, invasion, and metabolism of bladder cancer cells through the miR-767-3p/HIF1A pathway.	bladder
Intraoperative urothelial carcinoma tumor thrombus embolization to the heart: a case report.	Urothelial carcinoma (UC) rarely presents with an inferior vena cava (IVC) tumor thrombus. Herein, we report the case of a patient with UC in whom the thrombus embolized to the right atrium during resection. Intraoperative echocardiography identified the large embolus measuring greater than 4 cm and prolapsing through the tricuspid valve. The tumor thrombus was removed via sternotomy. This case is significant for the following learning points: 1) tumor thrombus should be managed with care during removal as it can embolize; 2) intraoperative transesophageal echocardiography is vital in these cases; and 3) a multidisciplinary approach including cardiac surgery is imperative to ensure optimal outcomes.	bladder
Durable complete response to PD-1 inhibitor in vesical calculus-associated squamous cell carcinoma: a case report.	BACKGROUND: Bladder squamous cell carcinoma (SCC) is a rare histological subtype of bladder cancer (1%-5% of cases), with radical cystectomy as the primary recommended treatment. However, evidence for neoadjuvant/adjuvant chemotherapy or immunotherapy remains limited, especially for calculus-associated SCC. CASE PRESENTATION: A 45-year-old male with vesical calculus-associated bladder SCC refused surgery and radiotherapy, and discontinued gemcitabine-cisplatin chemotherapy due to severe toxicity. He received tislelizumab (programmed death-1/PD-1 inhibitor, 200 mg q3w) and achieved a complete response (CR) after 8 cycles. Suprapubic cystolithotomy was safely performed during immunotherapy, and no tumor recurrence was observed for >24 months. Throughout the entire immunotherapy course, no severe immune-related adverse events occurred. CONCLUSION: Tislelizumab monotherapy may be a viable option for surgery-ineligible or chemotherapy-intolerant calculus-associated bladder SCC. Definitive stone removal under immunological tumor control is feasible, supporting further exploration of PD-1 inhibitors in this rare subtype.	bladder
Semi-supervised medical image segmentation of bladder tumors based on supervised branches and uncertainty estimation.	Supervised learning has excellent segmentation performance in bladder tumor segmentation, but it relies on a large amount of labeled data. To learn the features of bladder tumors from limited labeled data and obtain accurate segmentation results, we propose a semi-supervised segmentation method for bladder tumors, UDS-MT. The method consists of a Mean Teacher network and a guided branch, which respectively undertake the tasks of segmentation prediction and supervision of prediction results. Mean teacher network uses the exponential moving average (EMA) mechanism to update the teacher network parameters to achieve fine-grained capture of the target shape; the guided branch uses uncertainty estimation to filter out pixel blocks with high confidence to obtain more reliable masks, and it suppresses overfitting on some certain extent. In addition, we propose a defend loss term that only calculates the loss for pixels with high prediction confidence of the model, thereby improving the reliability of the pseudo-label. After evaluation on a bladder tumor clinical medical image dataset, when the labeled data is limited to 15%, the Dice coefficient of the network segmentation target shape can reach up to 80.04%, which is at least 2.81% higher than other methods.	bladder
Decoding SIGLEC12 in Bladder Cancer: In Silico Profiling of Expression, Tumor-Immune Interactions, and Prognostic Impact.	Background and Objectives: Siglec-XII, encoded by SIGLEC12, is a unique sialic acid-binding immunoglobulin-like lectin. It lacks a highly conserved R122 residue for sialic acid recognition in humans. Although it is upregulated in bladder cancer (BCa), its role in tumorigenesis remains largely unexplored. This study aims to investigate the expression patterns of SIGLEC12 in BCa and its correlation with disease features. Materials and Methods: An integrated analysis of transcriptomic data and clinical profiles was conducted using various databases and tools, including UALCAN, GEPIA, TIMER, CAMOIP, and CPADs. The analyses encompassed SIGLEC12 expression, survival rates, immune infiltration levels, promoter methylation, and correlation with drug response. Results: SIGLEC12 expression was higher in both low-grade papillary and high-grade invasive non-papillary BCa. Higher SIGLEC12 expression resulting from low promoter hypomethylation was detected at the stage II-IV of BCa, and was unrelated to disease stages and metastatic stages. Elevated SIGLEC12 expression correlated with increased immune cell infiltration, higher expression of oncogenic and immune checkpoint blockade-related genes, and drug resistance signatures. Mutation analysis confirmed the absence of the canonical R122 missense mutation, indicating that the structural integrity and potential functionality of Siglec-XII are preserved in BCa. Conclusions: SIGLEC12 may have sialic acid recognition functions and serve as a potential early biomarker of BCa.	bladder